Attribution is the hard part
Rapid weight loss by any means raises gallstone risk. Separating that from a direct drug effect requires a comparator, and the trials have one.
Nutrition
Page 4 of 11 of this archive, newest first.
The supplement trade found this drug class quickly, and the citations did not improve
A survey of what the meta-analyses support, with the populations named.
Severity grading, and the gap between a grade and an experience
Severity in these tables is graded by interference with activity, not by how unpleasant the experience was. Those are different measurements.
Why "muscle-sparing" is a marketing term and not a measurement
A tour of the source literatures, with an assessment of how far each legitimately reaches.
Background rates, and why they matter for attribution
Pancreatitis is rare, was adjudicated in the outcome programmes, and did not show the imbalance early case reports suggested.
Fat mass fell more than lean mass. That is the finding, and it is not the headline.
What was pre-specified, what was exploratory, and what was calculated afterwards by people who did not run the trial.
Gallstones during rapid weight loss: drug, or weight loss?
Pancreatitis is rare, was adjudicated in the outcome programmes, and did not show the imbalance early case reports suggested.
What a low result means when intake has halved
Micronutrient guidance for this drug class is borrowed almost entirely from post-bariatric surveillance, where the anatomy is different and the deficiency mechanisms are not…
The interventions with trial support, and the much longer list without
Dietary measures are widely recommended, plausible on mechanism, and supported mainly by observational data and clinical experience.
The out-of-range flag is a statistical convention with a printer attached
Two sources of noise sit under every number: how reproducible the assay is, and how much the analyte varies within the same person on the same day.
Discontinuation rates, read honestly
The ceiling varies severalfold between people, and nothing measurable at baseline predicts where it sits.
Why your endoscopist wants to know about your injection
This is the single interaction with ordinary medical care that patients most need to disclose, and it is the one most often not asked about.
Pancreatitis, obstruction, gallbladder: three things nausea can be
Rapid weight loss by any means raises gallstone risk. Separating that from a direct drug effect requires a comparator, and the trials have one.
Why your laboratory interval differs from the one in the textbook
A twelve-analyte panel in a perfectly healthy person has roughly even odds of producing at least one flagged result.
Reading the semaglutide composition data without the press release
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
The one randomised trial that combined an incretin with supervised exercise
The recommendation survives scrutiny. The reasoning offered for it frequently does not.
Rapid weight loss moves eight analytes for reasons that have nothing to do with the drug
Three different explanations for the same abnormal number, and how to tell them apart.
Rapid weight loss moves eight analytes for reasons that have nothing to do with the drug
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
Which results should be repeated before they are investigated
Timing is the whole of the post-cessation panel: draw it too early and it measures the treatment period.
The mechanism behind the mechanism
The clinical effect profile is almost fully predictable from where the receptor is expressed, which is unusual and useful.